# Understanding and targeting stress reactivity in women Veterans with alcohol misuse

> **NIH VA IK2** · NORTHAMPTON VA MEDICAL CENTER · 2020 · —

## Abstract

Objectives: The overall objective of the proposed CDA-2, “Understanding and targeting stress reactivity in
women Veterans with alcohol misuse”, is for the candidate to receive mentored training on, and to develop
skills for, conducting research among women Veterans. Women are expected to comprise 35% of the U.S.
Veteran population by 2035, making them the fastest growing segment of VHA users. Within this growing
population, understanding their particular clinical needs will become increasingly important. Alcohol misuse is
one clinical issue salient for women Veterans. Recent estimates of lifetime alcohol use disorder among women
Veterans are up to 27%, equaling those of their male counterparts and exceeding those of civilian women, and
women with alcohol misuse have high rates of co-occurring posttraumatic stress disorder (PTSD). Training
goals of the CDA-2 grant include learning novel research methods, neurobiological markers of stress and
addiction, advanced statistics, and professional development, all within the context of improving care for
women Veterans. Aims for the study proposed in this CDA-2 project are two-fold: 1. conduct a randomized trial
testing the effects of an emotion regulation skill (cognitive reappraisal) on stress-induced drinking among
women with alcohol misuse and varying levels of co-occurring PTSD; 2. examine whether progesterone levels
and/or severity of co-occurring PTSD – factors which impact women’s stress reactivity and emotion regulation
– moderate the effectiveness of the cognitive reappraisal in reducing stress-induced drinking. Research has
shown that serum levels of progesterone and its metabolites are associated with less stress reactivity, less
alcohol craving and use, and better ability to regulate emotion. Women with PTSD, however, exhibit a deficit in
progesterone metabolism, and women’s alcohol use and craving has been shown to fluctuate across the
menstrual cycle. This research suggests that women with low progesterone levels, within the context of
menstrual cycle phase or co-occurring PTSD, may be particularly prone to stress-induced drinking and may
benefit from learning and using effective emotion regulation skills. Methods: The proposed study will use
innovative methodology, combining experimental sessions in a randomized trial with daily longitudinal data
collection. Each woman Veteran (n=60) will be randomized to one of two conditions: a control condition (n=30)
or a condition in which participants learn to use cognitive reappraisal to regulate stress and negative emotion
(n=30). Women in the cognitive reappraisal condition will be asked to practice and use this skill over a 35-day
period (to encompass an entire menstrual cycle), and will complete daily logs of alcohol use and stress. Each
participant will come in for two experimental sessions, scheduled at the time of her peak and lowest
progesterone levels, during which participants in the cognitive reappraisal condition will use that skill in
r...

## Key facts

- **NIH application ID:** 9780689
- **Project number:** 1IK2CX001951-01
- **Recipient organization:** NORTHAMPTON VA MEDICAL CENTER
- **Principal Investigator:** Cathryn Glanton Holzhauer
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2019-10-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9780689

## Citation

> US National Institutes of Health, RePORTER application 9780689, Understanding and targeting stress reactivity in women Veterans with alcohol misuse (1IK2CX001951-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9780689. Licensed CC0.

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